Polikistik over sendromu ve oksidatif stres

Yıl 2025, Cilt: 8 Sayı: 1, 10 - 15, 31.01.2025

Şerif Hürriyetoğlu , Ahmet Beyazıt , Ali Hakverdi

https://doi.org/10.53493/avrasyasbd.1426544

Öz

Amaç: Reprodüktif dönemdeki kadınlarda polikistik over sendromu (PCOS) en sık görülen endokrin bozukluklarından birisidir. Çok yaygın olmasına rağmen patogenezi halen belirsizdir. Oksidatif stres öne sürülen mekanizmalardan birisidir. Çalışmamızda PCOS hastalarındaki klinik ve labaratuar bulgularını ve oksidatif stres parametrelerini değerlendirmeyi amaçladık.
Yöntem: Prospektif olan çalışmamıza Rotterdam kriterlerine göre tanısı konulmuş 75 PCOS hastası ve kontrol grubu olarak 75 sağlıklı kişileri aldık. Katılımcıların demografik verileri ve menstrüel siklus düzeni sorgulandı. Lipid profili, insulin direncine bakıldı. Hirsutizm değerlendirmesi için Ferriman-Gallwey skorlaması ve androjen düzeyleri çalışıldı. Oksidatif stres belirteçlerinden süperoksit dismutaz (SOD), katalaz ve urotensin-2 bakıldı.
Bulgular: PCOS grubunun yaş ortalaması 23.1 kontrol grubunun ise 27 olarak saptandı. PCOS grubunda 47.9 olan menstrüel siklus süresi kontrol grubunda 27.5 olarak bulundu (p<0,05). Ferriman-Gallwey skoru PCOS grubunda daha yüksekti (p<0.05). Lipid profili değerlendirildiğinde anlamlı olmamakla birlikte kontrol grubunda daha kötü bir lipid profili mevcuttu. Çalışmamızda oksidatif stresi değerlendirmek için SOD, katalaz ve urotensin-2 düzeyleri çalışıldı. Her üç parametrede PCOS grubunda daha yüksek saptandı katalaz ve ürotensin için p<0.05; SOD için p>0.05).
Sonuç: PCOS etiyolojisi halen net ortaya konulamamış sendromlar grubudur. Çok çeşitli klinik ve labaratuar bulguları vardır. Oksidatif stres patogenezde öne sürülen teorilerden birisidir.

Anahtar Kelimeler

Polikistik over sendromu, Oksidatif Stres, İnsulin Direnci

Etik Beyan

Mustafa Kemal Üniversitesi Tayfur Ata Sökmen Tıp Fakültesi Klinik Araştırmalar Etik Kurul Kararı No: 27/10/2016/171

Polycystic ovary syndrome and oxidative stress

Öz

Objective: In reproductive age, polycystic ovary syndrome (PCOS) is one of the most common endocrine disorders in women. Although it is a very common, pathogenesis is still unclear. Oxidative stress is one of the proposed mechanisms. In our study, we aimed to evaluate the clinical and laboratory findings and oxidative stress parameters in PCOS.
Methods: In our prospective study, we included 75 PCOS patients, diagnosed according to the Rotterdam criteria, and 75 healthy people as the control group. Participants' demographic data and menstrual cycle patterns were questioned. Lipid profile and insulin resistance were examined. Ferriman-Gallwey scoring and androgen levels were studied to evaluate hirsutism. Superoxide dismutase (SOD), catalase and urotensin-2, which are oxidative stress markers, were measured.
Results: The average age of the PCOS group was 23.1 and the control group was 27. Menstrual cycle duration was 47.9 versus 27.5 in the PCOS (p<0.05). Ferriman-Gallwey score was significantly higher in the PCOS group (p<0.05). There was a worse lipid profile in the control group (p>0.05). In our study, SOD, catalase and urotensin-2 levels were measured to evaluate oxidative stress. All three parameters were found to be higher in the PCOS group (for catalase and urotensin 2 p<0.05; for SOD p>0.05).
Conclusion: PCOS is a group of syndromes whose etiology is still unclear. It has a wide variety of clinical and laboratory findings. Oxidative stress is one of the theories put forward in pathogenesis.

Anahtar Kelimeler

Polycystic Ovary Syndrome, Oxidative Stress, Insulin Resistance

Kaynakça

• Agarwal A, Aponte-Mellado A, Premkumar BJ, Shaman A, Gupta S. The effects of oxidative stress on female reproduction: a review. Reprod Biol Endocrinol. 2012;10:49. Published 2012 Jun 29. doi:10.1186/1477-7827-10-49
• Allen RG, Tresini M. Oxidative stress and gene regulation. Free Radic Biol Med. 2000;28(3):463-499. doi:10.1016/s0891- 5849(99)00242-7
• Azarchi S, Bienenfeld A, Lo Sicco K, Marchbein S, Shapiro J, Nagler AR. Androgens in women: Hormone-modulating therapies for skin disease. J Am Acad Dermatol. 2019;80(6):1509-1521. doi:10.1016/j.jaad.2018.08.061
• Chukwunonso Obi B, Chinwuba Okoye T, Okpashi VE, Nonye Igwe C, Olisah Alumanah E. Comparative Study of the Antioxidant Effects of Metformin, Glibenclamide, and Repaglinide in Alloxan-Induced Diabetic Rats. J Diabetes Res. 2016;2016:1635361. doi:10.1155/2016/1635361
• Dabravolski SA, Nikiforov NG, Eid AH, et al. Mitochondrial Dysfunction and Chronic Inflammation in Polycystic Ovary Syndrome. Int J Mol Sci. 2021;22(8):3923. Published 2021 Apr 10. doi:10.3390/ijms22083923
• Di Meo S, Reed TT, Venditti P, Victor VM. Role of ROS and RNS Sources in Physiological and Pathological Conditions. Oxid Med Cell Longev. 2016;2016:1245049. doi:10.1155/2016/1245049
• Enechukwu CI, Onuegbu AJ, Olisekodiaka MJ, et al. Oxidative stress markers and lipid profiles of patients with polycystic ovary syndrome in a Nigerian tertiary hospital. Obstet Gynecol Sci. 2019;62(5):335-343. doi:10.5468/ ogs.2019.62.5.335
• Escobar Morreale HF. Polycystic ovary syndrome: definition, aetiology, diagnosis and treatment. Nat Rev Endocrinol. 2018;14(5):270-284. doi:10.1038/nrendo.2018.24
• Forman HJ, Zhang H. Targeting oxidative stress in disease: promise and limitations of antioxidant therapy [published correction appears in Nat Rev Drug Discov. 2021 Aug;20(8):652]. Nat Rev Drug Discov. 2021;20(9):689-709. doi:10.1038/s41573-021-00233-1
• Forrester SJ, Kikuchi DS, Hernandes MS, Xu Q, Griendling KK. Reactive Oxygen Species in Metabolic and Inflammatory Signaling. Circ Res. 2018;122(6):877-902. doi:10.1161/ CIRCRESAHA.117.311401
• Gunning MN, Sir Petermann T, Crisosto N, et al. Cardiometabolic health in offspring of women with PCOS compared to healthy controls: a systematic review and individual participant data meta-analysis. Hum Reprod Update. 2020;26(1):103-117. doi:10.1093/humupd/dmz036 Jeelani H, Ganie MA, Masood A, et al. Assessment of PON1 activity and circulating TF levels in relation to BMI, testosterone, HOMA-IR, HDL-C, LDL-C, CHO, SOD activity and TAC in women with PCOS: An observational study. Diabetes Metab Syndr. 2019;13(5):2907-2915. doi:10.1016/j. dsx.2019.08.001
• Kurutas EB. The importance of antioxidants which play the role in cellular response against oxidative/nitrosative stress: current state. Nutr J. 2016;15(1):71. Published 2016 Jul 25. doi:10.1186/s12937-016-0186-5
• Liu Y, Yu Z, Zhao S, et al. Oxidative stress markers in the follicular fluid of patients with polycystic ovary syndrome correlate with a decrease in embryo quality. J Assist Reprod Genet. 2021;38(2):471-477. doi:10.1007/s10815-020- 02014-y
• Lu J, Wang Z, Cao J, Chen Y, Dong Y. A novel and compact review on the role of oxidative stress in female reproduction. Reprod Biol Endocrinol. 2018;16(1):80. Published 2018 Aug 20. doi:10.1186/s12958-018-0391-5
• Monastra G, Vazquez-Levin M, Bezerra Espinola MS, Bilotta G, Laganà AS, Unfer V. D-chiro-inositol, an aromatase down-modulator, increases androgens and reduces estrogens in male volunteers: a pilot study. Basic Clin Androl. 2021;31(1):13. Published 2021 Jun 3. doi:10.1186/s12610-021- 00131-x
• Norman RJ, Dewailly D, Legro RS, Hickey TE. Polycystic ovary syndrome. Lancet. 2007;370(9588):685-697. doi:10.1016/ S0140-6736(07)61345-2
• Papalou O, Victor VM, Diamanti-Kandarakis E. Oxidative Stress in Polycystic Ovary Syndrome. Curr Pharm Des. 2016;22(18):2709-2722. doi:10.2174/1381612822666160216151 852
• Pasquali R, Gambineri A. Therapy in endocrine disease: treatment of hirsutism in the polycystic ovary syndrome. Eur J Endocrinol. 2013;170(2):R75-R90. Published 2013 Dec 21. doi:10.1530/EJE-13-0585
• Risal S, Pei Y, Lu H, et al. Prenatal androgen exposure and transgenerational susceptibility to polycystic ovary syndrome. Nat Med. 2019;25(12):1894-1904. doi:10.1038/ s41591-019-0666-1
• Rotterdam ESHRE/ASRM-Sponsored PCOS consensus workshop group. Revised 2003 consensus on diagnostic criteria and long-term health risks related to polycystic ovary syndrome (PCOS). Hum Reprod. 2004;19(1):41-47. doi:10.1093/humrep/deh098
• Shahveghar Asl Z, Parastouei K, Eskandari E. The effects of N-acetylcysteine on ovulation and sex hormones profile in women with polycystic ovary syndrome: a systematic review and meta-analysis. Br J Nutr. 2023;130(2):202-210. doi:10.1017/S0007114522003270 Sies H, Jones DP. Reactive oxygen species (ROS) as pleiotropic physiological signalling agents. Nat Rev Mol Cell Biol. 2020;21(7):363-383. doi:10.1038/s41580-020-0230-3
• Stener-Victorin E, Deng Q. Epigenetic inheritance of polycystic ovary syndrome - challenges and opportunities for treatment. Nat Rev Endocrinol. 2021;17(9):521-533. doi:10.1038/s41574-021-00517-x
• Toulis KA, Goulis DG, Mintziori G, et al. Meta-analysis of cardiovascular disease risk markers in women with polycystic ovary syndrome. Hum Reprod Update. 2011;17(6):741-760. doi:10.1093/humupd/dmr025
• Valko M, Rhodes CJ, Moncol J, Izakovic M, Mazur M. Free radicals, metals and antioxidants in oxidative stress-induced cancer. Chem Biol Interact. 2006;160(1):1-40. doi:10.1016/j.cbi.2005.12.009
• Wekker V, van Dammen L, Koning A, et al. Long-term cardiometabolic disease risk in women with PCOS: a systematic review and meta-analysis. Hum Reprod Update. 2020;26(6):942-960. doi:10.1093/humupd/dmaa029
• Yin W, Falconer H, Yin L, Xu L, Ye W. Association Between Polycystic Ovary Syndrome and Cancer Risk. JAMA Oncol. 2019;5(1):106-107. doi:10.1001/jamaoncol.2018.5188
• Zeber-Lubecka N, Ciebiera M, Hennig EE. Polycystic Ovary Syndrome and Oxidative Stress-From Bench to Bedside. Int J Mol Sci. 2023;24(18):14126. Published 2023 Sep 15. doi:10.3390/ijms241814126